Medicaid is a joint federal-state program that provides health coverage to:
- Many low-income disabled adults and children
- Some older adults
- Pregnant people and others with low income, depending on the state
Medicaid is especially important for disability because it can cover:
- Home- and community-based services (HCBS)
- Long-term care
- Personal care assistance
- Durable medical equipment
- Many medications and treatments
Key points:
- Rules differ by state, even though there are federal minimums.
- Many SSI recipients automatically qualify for Medicaid in their state.
- Some people qualify through income-based expansion or special disability-related pathways.
Common pathways include:
- Receiving SSI (in most states)
- Low-income adults under a certain income level (in Medicaid expansion states)
- Children with disabilities
- People needing long-term services and supports
- Medically needy or “spend-down” pathways in some states, where high medical costs are taken into account.
Because eligibility categories and income limits change, always check your state’s Medicaid agency or a local navigator.
Coverage varies, but often includes:
- Doctor visits, hospital care, emergency care
- Prescription medications
- Mental health and substance use treatment
- Physical, occupational, and speech therapy
- Wheelchairs and other durable medical equipment
- Personal assistance services
- Home- and community-based services (waivers)
- Long-term care in nursing homes or community settings
Many states offer waiver programs or HCBS that:
- Provide supports to keep people in their own homes or communities,
- May cover personal attendants, respite, supported employment, day programs, etc.
These programs often have waitlists.
You can usually apply:
- Through your state’s health insurance marketplace/portal,
- Directly through the state Medicaid agency, or
- Through local assistance offices, hospitals, or community organizations.
Documents often needed:
- Proof of identity and citizenship/immigration status (where applicable)
- Proof of income and, for some programs, assets
- Disability-related documentation, depending on the pathway
Common combinations:
- SSI + Medicaid
- Medicare + Medicaid (“dual eligibles”) – Medicare covers many medical services; Medicaid may help with premiums, cost-sharing, and long-term supports.
See also: